Dispelling nutrition myths, ranting, and occasionally, raving


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Is a spoonful of sugar the way to get the vegetables to go down?

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When I saw this article: “Sugar, salt or sweeteners may be key to getting children to eat greens” last week in the Nutrition Resource Centre “News in Brief” email I knew that I had to read more. I mean, were the authors really suggesting that we should add sugar to veggies to get infants and toddlers to eat them? Or was this just a case of a misleading or misinterpreted press release? I found a copy of the full article: Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables and set about reading.

One thing that struck me right away was that this study was done with adults, no infants or toddlers, or children of any age were involved in the research. Adult participants were provided with puréed vegetables (broccoli, kale, and spinach) with varying concentrations of added sugar. They were asked to rate them on various attributes, and most importantly, they were asked to indicate whether or not they liked or disliked each sample. I was surprised that the conclusion would be drawn that adding sugar to green vegetables is a reasonable means to encourage infants to eat them (I’m saying infants because these were puréed veggies and as such are really only suitable for babies just starting to eat solid foods) based on ratings by adults. After all, adults have very different palates than infants and have very different relationships with food that have been shaped over decades. To me it seems inappropriate to conclude that because adults preferred sugar sweetened veggies that infants will as well. The authors themselves also state that, “It should be noted that infants and toddlers are also not merely small adults”. However, they also use the analogy of adults beginning coffee consumption with added sugar and gradually weaning off the sugar as justification for proposing adding sugar to vegetables when the World Health Organization, among many other bodies, is currently encouraging reduced consumption of added sugars.

The second thing I wondered about was precisely how much sugar was added to each serving of vegetables. The news article, and much of the journal article, references 1% and 2% concentrations but what did that translate to in teaspoons or grams? It sounds pretty innocuous, right? 1% or 2% is hardly anything. Well, in actuality the 1% was equivalent to the addition of 1/2 teaspoon per serving and the 2% was equivalent to 1 teaspoon per serving. Not an insignificant amount when you’re talking about toddlers who are generally only consuming a tablespoon or two of a food in a serving. Interestingly, the researchers asked parents how comfortable they would be offering their babies vegetables with added sugar in amounts of 8 calories, 16 calories, 1/2 teaspoon, or 1 teaspoon. The 8 calories = 1/2 teaspoon = 1% concentration. The 16 calories = 1 teaspoon = 2% concentration. Essentially asking: how can we frame this added sugar to make it more palatable to parents who are trying to feed their children healthy diets?

Despite the general conclusion that adding sugar to vegetables may encourage young children to eat them, even the ratings by adults were not overwhelmingly improved by the added sugar. For broccoli and kale purées both 1% and 2% sugar increased overall liking. For spinach the 2% sugar (but not the 1%) increased overall liking. For broccoli and spinach the sugar increased the ratings of liking from disliked to liked. However, for kale, even at the highest sugar level ratings never rose above the midpoint (i.e. neither like nor dislike). So, these adults did not like any of the green vegetables to begin with (at least not in puréed form) but after adding higher quantities of sugar they liked the spinach, and even with the smaller quantity of added sugar they liked the broccoli. But neither amount of sugar was enough to get them to like the kale. Would babies have different initial reactions to these vegetables? Would the addition of sugar cause them to change these reactions? I don’t know and I don’t think anyone can say based on the results of this study alone.

Just for fun, I took a look at the funding sources for the study after I finished reading it. Can you guess what one of the funding organizations was? If you guess the Sugar Association you’d be correct. I think this explains a lot because honestly I was a bit baffled as to why anyone would be looking into adding sugar to get babies to eat vegetables and why such tenuous conclusions would be drawn and publicized based on the actual findings. But who other than the Sugar Association would think that we need to encourage babies to eat more sugar?

I think a better analogy than the sugar sweetened coffee for this research would be the argument that chocolate milk is a good way to get kids to drink milk or that baking apples into a pie is a good way to encourage fruit consumption. In some ways it’s even worse because infants are at the mercy of their caregivers when it comes to what foods are offered to them and encouraging a preference for only sweet foods at such a young impressionable age could have long lasting implications for their food choices and health throughout their lives.

 


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Is healthy food cheaper? Is that even the question?

 

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Continuing on with my ranting discussion about food security, I can’t help but comment on a study out of England that was getting huge media attention over the past couple of weeks. The study showed that “pound for pound” it was less expensive to eat healthy foods than to eat ultra-processed foods. The majority of the news stories concluded that poor people could be eating healthfully they just prefer to pay more for “taste and convenience”, according to one of the study’s authors. To which I say, check your privilege.

As I’ve said before, food insecurity is not a matter of simple math. While there are certainly myriad factors that contribute to our decisions about what to eat, lack of income is the root cause of food insecurity. Dismissing money as a concern on the basis of this study is wishful thinking more than anything. It’s also an insult to people who are struggling to make ends meet and feed themselves and their families.

Because some researchers went to the store and found that a pound of carrots is cheaper than a pound of french fries, the logical conclusion is that everyone should be able to afford to eat nutritious meals prepared from minimally processed ingredients? That seems like quite the leap to me. There’s no accounting for calories or ease of preparation in this comparison. Sure, a pound of vegetables may be less expensive than a pound of frozen ready-meals but I think that most people would agree that carrots do not make a balanced meal on their own. To make a nutritionally balanced meal, you’d need to round those carrots out with some dark green leafy veg, some protein like meat, fish, beans, or tofu (the authors acknowledge that meat and fish are the exception to their affordability rule), and a grain such as rice, quinoa, or whole grain bread. As most of these items need to be purchased in quantities greater than those needed for a single meal, it can quickly become more expensive to buy ingredients for a home cooked meal than it is to buy something already, or nearly, prepared. Yes, pound for pound, a bag of rice will be less expensive than frozen dinners but a bag of rice doesn’t make for much of a meal.

Stop trying to use your research to “prove” that poor people are choosing to feed their children junk. Take a good hard look at your own privilege and ask yourself how you can make this a more equitable society in which we try to help those who are struggling rather than shaming and blaming them.

 


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Science is not my religion

After I wrote about the study that supposedly showed that consumption of vegetables and fruit has no bearing on cancer development someone commented on facebook that I was undermining “real science” and supporting pseudo-science hacks. I think this raises an important issue when it comes to science and faith.

You see, while I am a supporter of science and detractor of pseudo-science, science is not my religion. I think that holding blind faith in anything is dangerous. Scientific research is hugely important but that doesn’t mean that every piece of research should be taken as gospel. Scientific studies can be flawed, they can be weak, they can be biased, and they can just plain be wrong. That doesn’t mean that we should ignore all scientific studies. It means that we should look at research critically. Whenever possible, we should look at larger bodies of research, rather than single studies, to draw stronger conclusions. We should look at research critically in order to base our decisions, beliefs, and advice on the best possible evidence.

Science is not infallible. That doesn’t mean that we ignore it. It just means that we need to examine it closely before deciding whether or not we accept results and conclusions drawn. Always question things. Be skeptical.

Rather than thinking that being critical of any piece of scientific research is on-par with supporting pseudo-science and quackery, we should think of blindly accepting the results of every piece of scientific research as being on-par with blindly accepting the advice of celebs and self-styled wellness gurus.


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Cruciferous crusaders or (not so) superfoods? The truth about veggies & cancer

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Did you hear the news? Last week it was announced that there’s no evidence of a link between vegetable and fruit consumption and risk of developing cancer. This proclamation was based on the results of a large-scale analysis of data from cohort studies in Japan.

Before everyone rejoices and throws the contents of their crispers in the compost, opting instead to have ice cream for supper maybe we should take a closer look at the original research.

The first caution I’d make is that this is based on a study of people in Japan. Because the average Japanese diet and lifestyle differs significantly from our North American diet and lifestyle we can’t conclude that results seen in people in Japan will apply to people in Canada or the US, or pretty much any other country.

The second caution, and this is the big one, is that the frequency of consumption of vegetables and fruit used in the study was very different from what’s recommended here. The greatest consumption of veg and fruit recorded in the study was “almost daily”. Compare that to the recommended 8-10 servings per day in Canada’s Food Guide. Stating daily consumption of veg and fruit tells us very little about the true picture of veg and fruit consumption. This categorization allows a person who eats one apple a day (and no other veg or fruit) to be viewed as the same as a person who eats veg and/or fruit at every meal and snack and consumes a wide variety of produce. The method of categorization in this study really only allows us to conclude that at minimal consumption levels, eating vegetables and fruit doesn’t appear to provide protection against cancer when compared to eating vegetables and fruit infrequently (or almost never??). The fact that almost never is even an option makes me wonder about the accuracy of self-reporting and the possibility that people in that group could be more likely to succumb to ailments such as scurvy before cancer would have a chance to get to them.

The third point to mention (although hopefully I don’t need to) is that absence of evidence is not evidence of absence. Just because this study didn’t find a relationship between the consumption of vegetables and fruit and the development (or prevention) of cancer doesn’t mean that there isn’t a connection between the two. It’s possible that using different parameters might show that a greater consumption of vegetables is linked to a decreased risk of certain types of cancer.

The final point that I think is important to make is that we don’t eat food in order to prevent cancer. Even if this study is showing us that eating vegetables and fruit doesn’t confer protection against cancer upon us (and I’m not even remotely convinced that it does) there are plenty of other good reasons to eat vegetables and fruit. Vegetables and fruit provide us with many vitamins and minerals that are vital to the function of our bodies. They provide us with fibre which is essential for gut health. They provide us with water and energy, which are both necessary for our survival. They also add flavour, colour, and variety to our diets making meals and snacks enjoyable. All this to say that while cookies are delicious they still aren’t a balanced nutritious meal. Vegetables and fruit still have important roles to play in keeping us healthy.


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Is store bought baby food better than home cooked?

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When I saw this article in the Daily Mail (yeah, I know) last week I knew that I had to read the original research to see what it said. As a dietitian I’m always trying to encourage people to cook their own meals. When I talk to mums about introducing their babies to solid foods I suggest that they see it as an opportunity to enjoy balanced meals as a family. Just what I need is headlines and articles proclaiming that pre-made store bought baby food is healthier than what ever they might be preparing at home.

I was frustrated to be unable to see the list of cookbooks the authors used in this study. The link just takes me to Amazon, and the list of the most popular baby food cookbooks they used was complied in 2013 so any results I might find could be considerably different today. Naturally, I worry about the use of baby food cookbooks as a comparison to ready-meals as they tend to be written by people with limited (or no) nutrition credentials (*cough* Pete Evans *cough*. Cookbooks are also quite unlikely to provide a true picture of what parents are feeding their children.

The obvious conclusion to draw from the study is that home cooked meals are superior (from both a cost and nutritional standpoint) to ready meals (at all ages) provided parents are preparing foods without added salt and sauces. The authors didn’t seem to reach this conclusion though. Perhaps the disingenuous comparison between cookbook recipes and ready meals, and the conclusion that ready meals may be better for babies, had something to do with the funding they received from Interface Food and Drink, an organization aimed at connecting the food and drink industry with researchers.

So, we know that home cooked meals can be healthy if parents don’t waste their money on special baby cookbooks. I think that it’s also important to note that the researchers were comparing quantities based on recipe yields and packages, not what babies are actually eating. Even if babies were eating recipes prepared from these cookbooks, they may not be eating every bite. Babies are much better than us adults at knowing when they’re full. If parents are respecting their babies cues and only feeding them as much as they show a desire to eat then it shouldn’t matter how much a recipe makes, or how much is in a package.

The true message from this study should be that you don’t need to waste your money on baby food cookbooks. Nor do you need to waste your money on packaged baby foods. Most babies will thrive on, and enjoy, a variety of simply prepared “normal” foods.

If you’re looking for more information on starting your baby on solids, I recommend visiting Best Start as well as watching this video from Toronto Public Health. If possible, sign-up for an infant feeding class through your local public health office.